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Thursday, May 31, 2012

Sex (in the) Machine

I have wanted to write about this issue for a few months now
and have finally gotten around to it. Science writer Kayt Sukel created a small
splash in the blogosphere in January when she wrote a few blog posts (see here
and here)
about her experiences orgasming in an MRI machine (or, as she puts it, “coming
for science”) as part of a study conducted by Barry Komisaruk and Nan Wise at Rutgers
University. Sukel’s posts were intended to serve as teasers for her book, Dirty
Minds: How Our Brains Influence Love, Sex, and Relationships (full
disclosure, I haven’t read her book yet). For an earlier account of an attempt
to “come for science” see science writer Mary Roach’s highly entertaining book,
Bonk:
The Curious Coupling of Science and Sex.

About the Research
and Its Contributions:

Barry Komisaruk
has been a pioneer in the use of fMRI to study orgasm (for an example of his
work, see here), and a
number of other researchers have also used PET and fMRI technologies to try to understand
what is going on in the human brain during sexual arousal and climax (for a
recent review of this research see Georgiadis
2012).

Komisaruk method’s are interesting – the team creates a
plastic mask for each subject based on a mold taken of her face. After the
subject puts on the mask, the mask is bolted to the scanner. This helps to keep
movement to a minimum as the subject stimulates herself to orgasm. The results
are also interesting – the team created a video
showing the changes in activation that occurred in Nan Wise’s brain as she
stimulated herself to orgasm (I’m curious if Komisaruk has ever masturbated to
orgasm inside an MRI machine). In general terms, activation occurred first in
the genital regions of the sensory cortex, then the limbic system (emotions and
long-term memory), then the cerebellum and the frontal cortex. During climax,
activity was greatest in the hypothalamus (probably related to the release of
oxytocin) and the nucleus accumbens (probably related to the release of
dopamine). After climax, activation levels decreased across the brain.

This is undoubtedly valuable research, and, as both Sukel
and Roach point out, scientists studying sexuality often face both a lack of
funding and a lack of respect when attempting to investigate questions related
to sexuality. However, I have some misgivings about the study, related to the
purpose of the research and to its ecological validity and representativeness.

Misgivings: Purpose
of the Research

According
to Komisaruk, one of the goals of the research is to understand how
pleasure works in the brain, which seems laudable. However, the goal of
understanding alone is rarely enough to get research funding, and, not
surprisingly, Komisaruk also sees “therapeutic” applications for his research,
specifically to address what he calls the “pathological” condition of
“anorgasmia.” Komisaruk is attempting to develop therapy for anorgasmia involving
neurofeedback, in which people are able to view their own brain activity on a
screen in “real time” and direct their bodies to respond.

Although this may be a useful tool for some people who are
trying to learn how to orgasm, I am wary of the language of pathology. Feminist
scholars have offered a number of critiques of the pathologization and
medicalization of benign sexual variation, pointing out that medicalization can
create unnecessary distress (why can’t I have an orgasm, why?) as well as puts
forth narrow solutions focused only on changing the individual rather than
society. I don’t have the space here to summarize these critiques fully;
instead, I refer you to the work of the New
View Campaign and to Liz Canner’s documentary, Orgasm Inc.

I will note that many women are probably already under plenty
of pressure to achieve orgasm. I will also note that some reporting on
Komisaruk’s research (for example, this
article) ties his research to the message that “sex is good for your
health,” a discourse that I have critiqued
extensively elsewhere.

I also have some misgivings about the ecological validity
and external validity or representativeness of this work. In terms of
ecological validity, it is always worthwhile to ask, to what extent do the
laboratory conditions approximate the real-life situation under investigation?
Probably for most women, the experience of self-stimulating to orgasm in an MRI
machine is very different from the experience of self-stimulating to orgasm in
“real life.” One of the most interesting parts of Sukel’s story is where she
talks about how she prepared for the study – for two weeks, she practiced stimulating
herself to orgasm with a bell taped to her forehead, in an effort to learn how
to bring herself to climax without moving her head. I think that because of the
poor ecological validity of this research, we would be wise to avoid assuming a priori that what goes on in the brain
during orgasm in a MRI machine is the same as what goes on in the brain during
orgasm in “real life.” In other words, we can’t just assume that an orgasm is
an orgasm is an orgasm, even within subjects.

In terms of external validity, it is also worthwhile to ask,
to what extent are the results generalizable to a larger population? Komisaruk’s
study is not the first study of the biological aspects of sexuality to raise
questions about generalizability. In the 1960s, William
Masters and Virginia Johnson undertook research into the physiology of sex.
Using a variety of instruments, they measured the physiological changes that
occurred in over 700 men and women engaging in masturbation and partnered
sexual intercourse in the laboratory. Masters and Johnson measured changes in
breathing, heart rate, genital swelling, muscle contraction, and genital color,
among other things. On the basis of their findings, they proposed a four-phase
model of “human sexual response” (excitement, plateau, orgasm, and resolution).
As many scholars have noted (Robinson
1976; Tiefer
2004; Irvine
2005), their sample was potentially biased for a number of reasons, perhaps
most significantly by the fact that Masters and Johnson studied only men and
women who were able to regularly orgasm during masturbation and heterosexual
intercourse. As Leonore Tiefer suggests, in essence, Masters and Johnson chose
women – those (few?) who were able to orgasm regularly during masturbation and intercourse – whose sexuality most
closely resembled the sexuality of men. Yet, although their sample was not
necessarily representative, their data was incorporated into the Diagnostic and Statistical Manual of Mental
Disorders and became the standard model of healthy sexual response. Even
today, a sexual response pattern that differs from that identified by Masters
and Johnson may be labeled pathological (Tiefer
2004).

According to Sukel, Komisaruk told her that only a few study
volunteers have been unable to stimulate themselves to orgasm in the MRI
machine. This suggests a few things – first, that maybe a fair number of women
are perfectly comfortable with, or are even turned on by, loud noises, confined
spaces, curious spectators, and immobilization devices. It also suggests that
Komisaruk’s volunteers may be a very specific type of women, with a very
particularly type of sexuality (i.e. a woman who doesn't need to use a vibrator). This itself is not a problem, the only danger
is if the sexuality of these women is established as the “norm” against which all
other types of sexuality are judged (as in what happened with Masters and
Johnson’s research).

Concluding Thoughts

Despite these misgivings, I am excited about this research
and can think of an infinite number of follow-up studies: is brain activation
similar for orgasms achieved through different types of stimulation? Is brain
activation similar for heterosexual, lesbian, and bisexual subjects? What is
the activation pattern when someone fakes an orgasm? Does a “food-gasm” produce
the same activation pattern as a “sex-gasm”?

What brain imaging orgasm studies would you propose and how
might the data from these types of studies be used to benefit society?

2 comments:

Really interesting stuff, Kristina. As somebody who has basically no familiarity with the study of sexuality, I think you raise some really compelling points about the limitations and pitfalls of current methods in the field. While it seems like many of those limitations are very difficult to correct - would it ever be possible to conduct an fMRI measuring orgasm in a woman who, for instance, only achieved orgasm under very narrow circumstances? - I certainly don't think that implicates the importance of pointing out limitations where they exist. Once those limitations are understood, I think this is fascinating research. Whether they WILL be understood, of course, is a more difficult question.

I think it might be interesting to study brain activation involved in various forms of fetishism, though - as you point out - there may be a danger in overpathologizing variations in sexuality. It might also be worthwhile to look at changes in brain activation that occur as a consequence of libido-limiting drugs such as antidepressants and (in some cases) cannabis; it seems possible that these sorts of studies could have applications in designing drugs that suppress or eliminate the sexual side effects of these substances.

Hi Ross,Thanks for your comments! I do think the important thing is to understand the limitations. And the limitations are even greater when you are trying to study sexual behavior involving more than one person (although people have tried).

Studying fetishes would be interesting (as long as the interest isn't in "curing" them) - although it might be difficult to accommodate many fetishes in an MRI machine. :) I think your suggestion about studying the effects of certain drugs that are known to inhibit orgasm is a great one.

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